Overall the book isn't one that adds up. Walker seems to vacilate between suggesting ADHD simply doesn't exist -- that it is always the symptom of an underlying problem -- and saying that there may be something to it if no underlying disorder can be found, but Ritalin isn't the answer. I found myself getting confused in spots about what he really believes.
His points about Ritalin are well made. He's absolutely correct in stating that it can be a risky drug for children to be on, that we haven't done enough appropriate longitudinal research, and that the side effects for some children can be problematic, at best. The key words, however, are some children. I know children who are on the drug who aren't having any problems with it. The whole issue of what is a cause and what is an effect is a confusing one, and this book doesn't make it any clearer.
In terms of the safety of Ritalin, the research and studies Dr. Walker mentions are based on such small sample sizes that they can't be taken as proof. His writing suggested to me that he was attempting to suggest causal relationships when he only had enough evidence to point out a correlation.
Now, Dr. Walker's points about HMOs and the lack of proper diagnosis of children are ones I can completely agree with. It's in this area that his evidence and argument is the strongest. He does a good job of explaining the different possible non ADHD causes of hyperactive behaviour. I did find this part of the book a bit long, however.
The latter parts of the book, dealing with advocating for your child with medical and educational professionals, is the most effective and useful part of the book. I would give the book two stars simply for the chapter where he gives readers observation sheets to fill out and give to the doctor as a basis for a proper medical examination. His advice on dealing with these professionals is sound and easy to implement -- he takes alot of the mystery and fear out of working with doctors and teachers. I would have like to see him encourage readers more to press for wider societal change, such as loosening the grip of HMOs and relieving some of the pressure on our schools -- changes that can only occur on a legislative/cultural level -- rather than simply pitting parents against doctors and teachers, however.
This book is worth looking at if you know nothing other causes of hyperactive behavior. It's got some useful information, but I wouldn't make it the only book I read on this subject.